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  • Conditions InDepth: Middle Ear Infection

    Otitis, or ear infection, can affect the external or the middle part of the ear. Middle ear infection (otitis media) is a very common form of ear infection, and most of this article will describe middle ear infection. The “middle ear” is the air-filled part of the ear that lies just behind the ear drum. Doctors cannot normally see the middle ear, but many middle ear problems will produce changes in the appearance of the ear drum that allow an appropriate diagnosis to be made.
    Ear infection can occur suddenly, leading to "acute otitis," or can last longer, as in "chronic otitis." External ear infections often occur after swimming or bathing. Sometimes it can be caused by manipulation of the ear canal, for example after the use of Q-tips. Middle ear infections may occur following a cold, or they may develop without a known cause. Ear infections are much more common in children than adults. For that reason, most of the information on these pages is geared toward children, although the same recommendations apply to adults as well.
    The Middle Ear
    Copyright © Nucleus Medical Media, Inc.
    Middle ear infections (otitis media) develop when bacteria or viruses get inside the ear and begin to multiply. These bacteria and viruses often enter the body as causes or complications of another respiratory infection, such as the common cold or a viral sore throat .
    Children are more vulnerable to otitis media than are adults. Two reasons for this difference in vulnerability are:
      Children have eustachian tubes which are smaller and straighter than those in adults.
      • The eustachian tubes connect the middle ear with the back of the nose and help to stabilize air pressure within the ear. In children, these tubes are smaller and straighter than in adults, a difference in anatomy, which makes it easier for bacteria to enter the middle ear from the nose and throat.
      Children have larger adenoids than do adults.
      • The adenoids are tonsil-like structures located just out of sight at the junction of the back of the nose and the upper throat. Like tonsils, adenoids tend to be much bigger in childhood than later in life. Ear infections may be more likely to develop when swollen adenoids block the nearby openings of the eustachian tubes.
    Ear infections are the most common infections in babies and young children. It is estimated that 75% of children under the age of 3 will experience as least one ear infection, and half of these children will have three or more ear infections by the age of 3. Although ear infections themselves are not contagious, the colds and other infections that frequently lead to ear infection can be passed from person to person.
    What are the risk factors for ear infections?What are the symptoms of ear infections?How is ear infection diagnosed?What are the treatments for ear infection?Are there screening tests for ear infections?How can I reduce my risk of ear infection?What questions should I ask my healthcare provider?Where can I get more information about ear infections?


    American Medical Association website. Available at: http://www.ama-assn.org/ .

    Centers for Disease Control and Prevention (CDC) website. Available at: http://www.cdc.gov/ .

    Gates GA. Cost-effectiveness considerations in otitis media treatment. Otolaryngol Head Neck Surg . 1996;114(4):525-530.

    Ferri’s Clinical Adviser . Mosby; 2001.

    National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/ .

    National Library of Medicine website. Available at: http://www.nlm.nih.gov/ .

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